Factoring the intestinal microbiome into the pathogenesis of autoimmune hepatitis

Table 3 Treatment considerations for investigation of gut-derived immune responses

Treatment Consideration	Nature	Findings
Dietary adjustments	Animal protein, saturated fats[90]	Bacteroides, Firmicutes (including Clostridia), and Prevotella favored by different dietary regimens[37,90]
	High carbohydrate diets[90]
	Low fat high fiber diet[90]
Probiotic preparations	Bifidobacterium bifidum[253]	Expands Tregs in cell culture[278]
	Lactobacillus strains[254,263,266]	Prevents diabetes in NOD mice[263]
	Lactobacillus rhamnosus[276]	Improves liver tests in rat model[266]
	Anaerostipes caccae[277]	Increases tight junction proteins[276]
		Consumes lactate and produces butyrate[277]
Vitamin A and retinoic acid	Retinoic acid supplement[255]	Restores Lactobacilli in lupus model[255]
	Dietary vitamin A[256]	Regulates cytokines in lupus model[256]
		Induces IL-10-producing Tregs[279]
Antibiotics	Tetracycline, minocycline[257]	Reduces activity in RA[257]
	Vancomycin, metronidazole[269]	Improves tests and pruritus in PSC[269]
Re-colonization	Bacteroides fragilis[107]	Induces Tregs in colitis model[107,109,110]
Fecal transplantation	Clostridia species[109,110]
Intestinal barrier protectors	Gelatin tannate[258-260]	Enhances mucus barrier[258,259]
		Reduces activity in murine colitis[259]
		Alters composition of microbiota[259]
		Limits inflammatory effects of LPS[260]
		Inhibits IL-8 and TNF-α in LPS cells[260]
TLR inhibitors	Oligodeoxynucleotides blocking TLR7 signaling[261]	Improves tests and reduces activity in murine model of lupus nephritis[261]
		Improves autoimmune lung injury[261]
Molecular interventions	Polysaccharide A[105,262]	Induces IL-10 producing Tregs[105,262]
		Protects against EAE in mice[105]
Short chain fatty acids	Acetate, propionate, butyrate[200]	Modulates gut signaling pathways[200]
		Inhibits histone deacetylases[200,264]
		Regulates gene expression[200]
		Enhances gut integrity[200]

Superscripted numbers in brackets are references. EAE: Experimental autoimmune encephalitis; IL: Interleukin; LPS: Lipopolysaccharide; NOD: Non-obese diabetes; PSC: Primary sclerosing cholangitis; RA: Rheumatoid arthritis; TLR: Toll-like receptor; TNF-α: Tumor necrosis factor-alpha; Tregs: Regulatory T cells.